Organization Active NPI

Integrated Pain Services Inc

  • Pain Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1508355181
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
INTEGRATED PAIN SERVICES INC
Practice address
3101 University Blvd S Ste 200
Jacksonville, FL 32216-2753
Phone
(904) 717-9625
Fax
(904) 683-6499
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Deborah Mendez-Vigo
Title
Credentialing Manager
Phone
(904) 982-7447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

3101 University Blvd S Ste 200
Jacksonville, FL 32216-2753

Mailing address

PO Box 550897
Jacksonville, FL 32255-0897
Phone (904) 717-9625

Other practice location 1

4063 Salisbury Rd
Jacksonville, FL 32216-8030
Phone (904) 717-9625 ext. 1020

National Provider Directory

National Provider Directory

Locations

4063 Salisbury Rd
Ste 110
Jacksonville, FL 32216
Phone (904) 717-9625

4063 Salisbury Rd
Jacksonville, FL 32216
Phone (904) 398-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1508355181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550897",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322550897",
            "telephone_number": "904-717-9625",
            "fax_number": "904-683-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 UNIVERSITY BLVD S STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162753",
            "telephone_number": "904-717-9625",
            "fax_number": "904-683-6499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4063 Salisbury Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168030",
            "country_code": "US",
            "telephone_number": "904-717-9625 x1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED PAIN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "MENDEZ-VIGO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "904-982-7447",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.